Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world, with approximately 500,000 new cases per year worldwide, and is the third leading cause of cancer deaths worldwide. The treatment of HCC includes surgical resection, liver transplantation, and palliative care, depending on the advancement of the disease. For patients with unresectable HCC, transarterial chemoembolization (TACE) has clinically been proven to be superior to conservative palliative treatment.
TACE therapy is usually performed by an interventional radiologist (IR). Generally, a microcatheter is positioned through a guidewire into the main artery that feeds the tumor. An emulsion of chemotherapy agent or mixture of agents (commonly doxorubicin and cisplatin) suspended in lipiodol (an oily contrast medium that is preferably retained by tumor tissue) is injected intra-arterially into the hepatic arteries that directly feed the tumor. This is followed by blocking the feeding arteries with an embolic agent. The combination of the chemotherapy and arterial occlusion leads to increased drug residency time with the tumor. Furthermore, by concentrating the drug within the tumor tissue, one might expect reduced systemic exposure. However, even with TACE, up to 50% of the administered drug enters systemic circulation.
Thus, in the treatment of HCC, there is a demand for new chemotherapy delivery systems to improve drug dose local to the tumor and to minimize systemic exposure.